Healthcare Provider Details

I. General information

NPI: 1235329897
Provider Name (Legal Business Name): PARADISE RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7017 KALANIANAOLE HWY
HONOLULU HI
96825-2007
US

IV. Provider business mailing address

1050 BISHOP ST STE 162
HONOLULU HI
96813-4210
US

V. Phone/Fax

Practice location:
  • Phone: 808-206-8462
  • Fax: 866-241-7463
Mailing address:
  • Phone: 808-206-8462
  • Fax: 866-241-7463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License NumberSTF 86
License Number StateHI

VIII. Authorized Official

Name: DR. JOHN PARTRICK NEUHAUS
Title or Position: MEDICAL DIRECTOR AND CO-FOUNDER
Credential: M.D.
Phone: 18083866332